Hierarchy of risk factors for chronic kidney disease in patients with type 2 diabetes mellitus

Diabetic kidney disease is a significant complication of type 2 diabetes mellitus and has a significant impact on quality of life and patient survival, both due to progression towards endstage kidney disease and associated atherosclerosis. Identification of the risk factors, especially in incipient kidney disease, is an important focus of research. The aim of our study was to rank the risk factors of two separate criteria for renal function: albumin excretion - quantified as urinary albumin/creatinine ratio (UACR) and GFR (glomerural filtration rate) in type 2 diabetes patients. Data from 53 type 2 diabetic patients were analyzed first with TOPSIS method and then compared with relative risk of each factor for UACR and GFR separately. 18 possible risk factors were taken in consideration. In the top of the TOPSIS method hierarchy was serum adiponectin (RR=2.06 for UACR and RR=1.65 for GFR) followed by C reactive protein (RR=1.74 for UACR and RR=1.02 for GFR), systolic blood pressure (RR=1.69 for UACR and RR=1.03 for GFR) and triglycerides (RR=1.57 for UACR and RR=0.96 for GFR). The Spearman coefficient of correlation between hierarchy provided by RR for UACR and TOPSIS method hierarchy was r=0.53, p=0.03. The Spearman coefficient of correlation between hierarchy provided by RR for GFR and TOPSIS method hierarchy was r=0.73, p=0.001. In conclusion, using TOPSIS method in this case brought new information about factors that may influence the occurrence of diabetic kidney disease.